National Association of Pet Pharmacies

I'm extremely pleased to report that 1-800-PetMeds pharmacy has been certified as an accredited pharmacy by the National Association of Pet Pharmacies (NAPP).

NAPP is "an independent and impartial organization established with the mission of ensuring the validity of pet pharmacies selling medications in the United States".

Similar to VIPPS, NAPP has certified that 1-800-PetMeds is licensed or authorized to dispense in all states that require licensure. Their website provides a list of the 1-800-PetMeds license numbers in those states, as well as a link to the regulatory agency for pharmacies in those states. In addition, the NAPP certifies the the products dispensed are EPA- or FDA-approved for sale in the United States.

November is National Diabetes Awareness Month

My apologies for not contributing since June. However, a discussion regarding Diabetes mellitus (Diabetes) and Diabetes awareness is a great way for me to begin writing again.

We hear and read time after time about the increased prevalence of Diabetes in the human population. Some causes can be attributed to a sedentary lifestyle, lack of exercise, diets full of carbs and starches as well as larger portions, all leading to an obese population.

This blog is really about pets, and in the dog and cat population, Diabetes is one of the most common endocrine disorders. Symptoms of Diabetes include increased thirst, hunger and urination, weight loss, and lethargy. In dogs, untreated Diabetes can cause rapid cataract formation. In cats, undiagnosed Diabetes can lead to diabetic neuropathy which is evidenced by the cat walking on it's hock (plantigrade posture). The incidence of Diabetes in the dog population has grown from 19 in 10,000 dogs 30 years ago to 58 per 10,000 as of 1999. In the cat population, the incidence of Diabetes can range from 1 in 50 to over 1 in 400 depending on the population studied.

Diabetes is easily diagnosed through a simple blood test and is most commonly categorized as Type I and Type II. Type I occurs mostly in dogs and is treatable with insulin. Type II occurs mostly in cats and is treatable with oral medication, although some cats are treated with insulin.

1-800-PetMeds carries a full line of products necessary for the treatment of Diabetes, as well as
a monitor to measure how effective treatment is. Here is a list of the products that we carry:

• Healthy Glucose Multivitamin
• IPet Glucose Monitoring Kit for Dogs and Cats
• IPet Test Strips
• Glipizide 5mg Tablets
• Vetsulin (for dogs and cats)
• PZI Vet Cat Insulin
• U-40 Insulin Syringes for Vetsulin and PZI Vet

PZI Vet Insulin has been discontinued by the manufacturer, and will no longer be carried once supplies have run out.

PZI-VET and Vetsulin Insulin

On April 8, 2008 IDEXX Pharmaceuticals, Inc. announced that they were discontinuing production of PZI-VET. PZI-VET a brand of U-40 Protamine Zinc Insulin was FDA approved for use in cats. There are still supplies at the retail level. However, once those supplies run out, PZI-VET will no longer be available. That's the bad news.

The good news is that Vetsulin, manufactured by Intervet/Schering-Plough, which was previously approved for use in dogs only, has received FDA approval for use in both dogs and cats.

PZI-VET and Vetsulin are not the exact same insulin. PZI-VET is protamine zinc insulin, whereas Vetsulin is porcine zinc insulin suspension.

As cats are moved from PZI-Vet to Vetsulin, the dose of Vetsulin will need to be adjusted and monitored by the veterinarian.

Keep Pets Safe From Fleas and Ticks

On March 19, 2008, 1-800-PetMeds issued a press release providing specific recommendations for pet owners to prevent flea and tick infestation on their pets.

In this article, Dr. Michael Dym, 1-800-PetMeds veterinarian, discusses the types of diseases caused by fleas and ticks.

The advantages of using products such as Frontline Plus and K9 Advantix as a means of preventing flea and tick infestations is discussed in this press release.

Disaster Plans for Your Pets

I live in southeastern Florida and June 1 marked the start of hurricane season. A few years ago, my wife and I were directly impacted by hurricane Wilma. In 1995, I was a pharmacist first responder when hurricane Andrew devasted the Homestead, Florida area. As a result of these hurricanes, my wife and I make it a point to review our disaster plan. We make sure our property is secure and that extra food, water and other necessary supplies are on hand prior to June 1.

I'm sure we've all read about the disasters affecting the mid-west. Torrential downpours, flooding, and tornadoes have been causing havoc to so many families.

My question to those of you that have not been affected by these disasters is; if an emergency such as flood, fire, tornado, or hurricane were to happen, how prepared are you? If you are not prepared, now is the time to mke sure you have a disaster plan in place and make sure your pets have been included in this plan.

In preparing a disaster plan, you need to consider what needs to be done before, during, and after a disaster. Let's look at these considerations:

Before a disaster strikes:

• If you must evacuate, take your pet with you, if possible. However, if you are going to a public shelter, know beforehand if the shelter is pet friendly. Not all shelters allow pets. You need to plan in advance for shelter needs for you and your pets.
• Is the pet current on vaccines? Pet friendly shelters may require proof of vaccination.
• Have a current picture of your pet.
• Make sure you have a collar, identification tag, and a leash on hand.
• Have a pet carrier for each pet large enough for the pet to stand in and turn around in.
• Don't forget to include your pet when creating your disaster plan.

During a disaster:

• If the shelter allows pets, bring along the collar with ID and rabies tags, leash, and pet carrier.
• Bring an ample supply of food, water, and food bowls.
• Bring any necessary medications and any specific care instructions.
• Bring newspapers or trash bags for clean up.

After A disaster:

• Pets may need to be reoriented to their home and should be kept on a leash since familiar scents and landmarks may be altered. In addition, pets can be easily confused and become lost.
• Have a picture of your pet with you in case your pet cannot be found after a disaster. Check with local authorities such as animal control to see where animals can be recovered.
• Be aware of behavior changes in the pet as a result of the disaster. Your pet may become aggresive or defensive.

Additional information on a disaster plan for dogs and a disaster plan for cats can be found on www.PetHealth101.com

China Earthquake Relief

This morning, I read an article in my local newspaper that mentioned pharmacy students at Nova Southeastern University College of Pharmacy have started a relief fund for victims of the recent earthquake in China. These students are raising money for food, medicine, potable water, blankets and temporary shelter for those who have been affected by the quake. These students will be working with Beijing University of Chinese Medicine to coordinate the relief efforts.

Doctor of Pharmacy students at Nova Southeastern University College of Pharmacy are required to perform 8 clinical rotations during the last year of their six year education. Four of these rotations are required and four are elective. 1-800-PetMeds serves as one of the elective sites and offers a rotation in Veterinary Pharmacy. I am a preceptor for those students wishing to take this elective rotation, and as such, serve as Clinical Affiliate Faculty at NSU College of Pharmacy.

I am proud to be affiliated with this university and equally proud of these students efforts. I know these future pharmacists will be assets to the profession.

1-800-PetMeds Supports Jacksonville, Florida "Fur Ball Gala"

On May 3, 2008, 1-800-PetMeds issued a press release that it will be supporting the Ninth Annual "Fur Ball Gala" in association with the Jacksonville, Florida Humane Society.

The gala event scheduled for May 31 at the University Center Ballroom will host 350 people and their more than 150 pets.

Angels' Eyes Tear Stain Remover at 1-800-PetMeds

1-800-PetMeds has recently added Angels' Eyes tear stain remover to the list of products offered for sale by the company. An eye care product composed of pure beef liver with Tylosin Tartrate as a preservative, Angels' Eyes is a unique product that helps eliminate tear stains from the inside out. As the stained fur around the eyes is trimmed, the newly grown coat will be totally clear.

Angels' Eyes is given as a dose based on the weight of the pet every day for the first 3 months. After 3 months the product is given 4 times a week, and after 6 months Angels' Eyes is given twice a week.

Angels' Eyes should be given to dogs 8 weeks of age or older. When giving Angels' Eyes, shake the powder container first, then sprinkle the dose onto an amount of food the pet will totally eat. In rare cases, where the pet does not like changes to their food, Angels' Eyes can be put into their drinking water. When mixing, always add water to the Angels' Eyes, do not pour the powder into the water.

ProMeris at 1-800-PetMeds

Fort Dodge Animal Health has introduced a new over-the-counter (OTC) product called ProMeris. This product is available as Promeris For Cats, for flea prevention in cats 8 weeks of age or older, and ProMeris For Dogs, for flea and tick prevention in dogs 8 weeks of age or older.

ProMeris For Cats and ProMeris For Dogs both contain the chemical metaflumizone. Metaflumizone blocks nerve impulses in the flea by targeting voltage dependent sodium channels on both sides of the nerve synapse. This new approach to flea control acts by blocking the influx of sodium which is required to allow nerve impulses to occur.

ProMeris For Dogs also contains the chemical amitraz to control ticks. Amitraz is classified as a monoamine oxidase inhibitor (MAOi). The manufacturer states that ProMeris For Dogs "contains a patent-protected formulation, which is designed to prevent absorption through the skin, It should not be compared with other amitraz formulations". Be that as it may, if your dog is using an MAOi such as Anipryl, selegiline, Mitaban Dip, or Preventic Collar, you should first consult your veterinarian before applying ProMeris For Dogs. People taking MAOi's (such as Parnate, Nardil, Eldepryl, and selegiline) should use particular care when applying this product and until the product is completely dry.

Tapeworms

This being the end of April, it's safe to assume that even the "colder" states are now beginning to warm up. This means that pets that were not treated with flea prevention products during the winter months should now be treated monthly. Flea prevention products that should be used include Advantage, Frontline and Program.

Why is flea prevention necessary? Fleas can transmit tapeworms which can cause symptoms in animals that include intense itching around the anus, causing dogs to "scoot" along the floor. They can also cause weight loss due to robbing nutrients from the intestinal tract, and they can also enter the stomach from the intestines causing stomach irritation. Fleas can also cause tapeworms in humans. Therefore, keeping our pets flea free and maintaining good hygiene, is necessary to prevent human contamination.

There are a number of interesting links I suggest you follow for more information. These include:
1. A tapeworms press release issued by 1-800 PetMeds on April 8, 2008

2. Articles on flea prevention including flea FAQ's and

flea control FAQ's

National Pet Dental Health Month

Of all the wonderful things we do for our pets, the one thing many of us do not do is take proper care of our pets teeth. It's not that we are lazy, or uncaring, it's just that it's not the most convenient, or easiest thing to do. After all, brushing or rinsing your pets teeth does take work.

However, dental care is not just about brushing. It's also about regular veterinarian visits to check on the dental health of our pet. It's about using products such as C.E.T. Chews, C.E.T. Toothpaste, and C.E.T. Rinse in a three stp process that is vital to the dental health of our pets.

This is National Pet Dental Health Month. Let's remind ourselvesthat it's just as important to take care of our pets teeth, as it is to give them their monthly heartworm preventative.

For more information regarding National Pet Dental Health Month please read our Press Release

Visit 1-800-PetMeds for more information regarding Dental Products

After I give the medication, then what?

How a medication works and how it is excreted from the body is a complicated topic. However, I believe consumers need to be informed and, therefore, I'm going to try and explain the process as simply as I can.


Medications undergo a process called biotransformation. For example:

• An active drug such as phenobarbital is converted, prior to excretion, to an inactive metabolite: hydroxyphenobarbital.


• An active drug such as primidone is converted, prior to excretion, to an active metabolite: phenobarbital.


• An inactive drug such as codeine is converted, prior to excretion, to an active metabolite: morphine.

It is either the active drug, or the active metabolite of the drug, that actually does the job it was intended to do, in the body.

Drugs eventually need to leave the body and the majority do so through the kidneys in urine. However, other drugs are excreted by the liver in bile .

Water soluble drugs are excreted through the kidneys either unchanged (ampicillin), or having been changed in the liver first (Rimadyl, Novox).

Other drugs pass through the liver and are excreted from the liver in bile. Bile enters the digestive tract and the drugs are eliminated via the feces. Examples are: ketoconazole (Nizoral).

As you can see the liver and kidneys play a major role. That's why it's important to make sure that these organs are functioning properly. In some cases, blood tests need to be performed before beginning drug therapy, and depending on the drug, during therapy to make sure there is no damage being done to the liver or kidney. When giving the pet more than one medication, kidney and liver health becomes even more important.

I'll try and expand on this subject in future entries.

Understanding Pharmacy Terms

There are times when medications are available in different dosage forms but the differences are not really understood. So here are the definitions of certain terms commonly used in pharmacy.

Chewable tablet (Chew tab) - a tablet that should be chewed, not swallowed whole.

Tablet - a medicine taken by mouth that is swallowed whole.

Caplet - a tablet that must be swallowed whole, but it's oblong shaped for ease of swallowing.

Softgel -a gelatin capsule usually containing a liquid.

Sprinkle Capsule - a capsule that is meant to be opened and sprinkled on food.

Scored - the tablet (or chew tab) can be split in half.

Double scored - the tablet can be split into quarters.

Suspension - a liquid that must be shaken well prior to use.

E.R. (ER) - Extended Release

Otic - for the EAR

Ophthalmic (Ophth.) - for the EYE

Topical - applied to the skin

Let me know if I can help with any other terms.